TY - JOUR AU - C. M. Smart AU - A. Reaume AU - N. Babaei AU - L. K. Qualls AU - M. J. Schaeffer AU - C. J. Kennedy AU - J. R. Gawryluk A1 - AB - OBJECTIVES: Escalating rates of opioid overdoses have led to a global public health crisis. With the widespread use of life-saving measures, such as Naloxone, more individuals are surviving overdoses. However, a secondary problem has emerged: many survivors are experiencing anoxic/hypoxic brain injuries (AHBI)-also known as toxic brain injuries-as a consequence of non-fatal overdose. This study aimed to explore the intersection of non-fatal opioid overdose and AHBI, identify barriers and facilitators to care, and inform the future development of an integrated care model for individuals with a history of opioid overdose and AHBI. METHODS: This study employed a mixed-method approach, combining qualitative semi-structured interviews with quantitative survey data. Participants included people with lived experience of non-fatal opioid overdose (PLE) and formal healthcare providers (HCP) from British Columbia, Canada. Data were collected using trauma-informed procedures and analyzed through thematic analysis and statistical methods to reveal key themes relating to service provision and care needs. RESULTS: PLE experienced cognitive challenges but had limited education about the overlap between AHBI and overdose. Significant gaps were identified by PLE in accessing and receiving care for both AHBI and substance use needs. HCPs expressed significant challenges with providing care, emphasizing factors such as limited resources and full caseloads. Both PLE and HCPs expressed that siloed care between brain injury, mental health and substance use was a fundamental, pervasive barrier. CONCLUSIONS: The findings indicate that individuals who survive opioid overdose and AHBI face complex challenges that necessitate integrated and tailored care approaches. To reduce the risk of secondary cognitive impairment and improve long-term recovery outcomes for this vulnerable population, essential steps include removing barriers to receiving and providing care, enhancing education for both patients and healthcare providers, and ensuring well-coordinated, long-term, culturally safe support. AD - Department of Psychology, University of Victoria, Victoria, BC, Canada.; Department of Psychology, University of Victoria, Victoria, BC, Canada; Institute on Aging & Lifelong Health, University of Victoria, Victoria, BC, Canada. Electronic address: nbabaei@uvic.ca.; Department of Psychology, University of Victoria, Victoria, BC, Canada; Institute on Aging & Lifelong Health, University of Victoria, Victoria, BC, Canada.; Department of Psychology, University of Victoria, Victoria, BC, Canada; Institute on Aging & Lifelong Health, University of Victoria, Victoria, BC, Canada; Canadian Institute for Substance Use Research, University of Victoria, Victoria, BC, Canada. AN - 42061724 BT - J Subst Use Addict Treat C5 - Opioids & Substance Use DA - 10/2026 DO - 10.1016/j.josat.2026.209989 DP - NLM ET - 20260428 JF - J Subst Use Addict Treat LA - eng N2 - OBJECTIVES: Escalating rates of opioid overdoses have led to a global public health crisis. With the widespread use of life-saving measures, such as Naloxone, more individuals are surviving overdoses. However, a secondary problem has emerged: many survivors are experiencing anoxic/hypoxic brain injuries (AHBI)-also known as toxic brain injuries-as a consequence of non-fatal overdose. This study aimed to explore the intersection of non-fatal opioid overdose and AHBI, identify barriers and facilitators to care, and inform the future development of an integrated care model for individuals with a history of opioid overdose and AHBI. METHODS: This study employed a mixed-method approach, combining qualitative semi-structured interviews with quantitative survey data. Participants included people with lived experience of non-fatal opioid overdose (PLE) and formal healthcare providers (HCP) from British Columbia, Canada. Data were collected using trauma-informed procedures and analyzed through thematic analysis and statistical methods to reveal key themes relating to service provision and care needs. RESULTS: PLE experienced cognitive challenges but had limited education about the overlap between AHBI and overdose. Significant gaps were identified by PLE in accessing and receiving care for both AHBI and substance use needs. HCPs expressed significant challenges with providing care, emphasizing factors such as limited resources and full caseloads. Both PLE and HCPs expressed that siloed care between brain injury, mental health and substance use was a fundamental, pervasive barrier. CONCLUSIONS: The findings indicate that individuals who survive opioid overdose and AHBI face complex challenges that necessitate integrated and tailored care approaches. To reduce the risk of secondary cognitive impairment and improve long-term recovery outcomes for this vulnerable population, essential steps include removing barriers to receiving and providing care, enhancing education for both patients and healthcare providers, and ensuring well-coordinated, long-term, culturally safe support. PY - 2026 SN - 2949-8759 SP - 209989 ST - Care access and provision for persons surviving opioid overdose and toxic brain injury, with recommendations to address the unfolding polycrisis T1 - Care access and provision for persons surviving opioid overdose and toxic brain injury, with recommendations to address the unfolding polycrisis T2 - J Subst Use Addict Treat TI - Care access and provision for persons surviving opioid overdose and toxic brain injury, with recommendations to address the unfolding polycrisis U1 - Opioids & Substance Use U3 - 10.1016/j.josat.2026.209989 VL - 189 VO - 2949-8759 Y1 - 2026 ER -